Ciprofloxacin

sip-roe-FLOX-a-sin

Oral routeTablet, Extended ReleaseSuspension

Fluoroquinolones, including ciprofloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. This risk is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants .

Fluoroquinolones, including ciprofloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. Risk further increases with age over 60 years, concomitant steroid therapy, and kidney, heart, or lung transplants .

Intravenous routeSolution

Fluoroquinolones, including ciprofloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. This risk is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants .

Fluoroquinolones, including ciprofloxacin, are associated with an increased risk of tendinitis and tendon rupture in all ages. Risk further increases with age over 60 years, concomitant steroid therapy, and kidney, heart, or lung transplants .

Oral routeTablet

Fluoroquinolones, including ciprofloxacin hydrochloride, are associated with an increased risk of tendinitis and tendon rupture in all ages. This risk is further increased in older patients usually over 60 years of age, in patients taking corticosteroid drugs, and in patients with kidney, heart or lung transplants .

Fluoroquinolones, including ciprofloxacin hydrochloride, are associated with an increased risk of tendinitis and tendon rupture in all ages. Risk further increases with age over 60 years, concomitant steroid therapy, and kidney, heart, or lung transplants .

Commonly used brand name(s):

In the U.S.

  • Cipro

Available Dosage Forms:

  • Powder for Suspension
  • Tablet

Therapeutic Class: Antibiotic

Chemical Class: Fluoroquinolone

Uses For ciprofloxacin

Ciprofloxacin is used to treat bacterial infections in many different parts of the body. Ciprofloxacin is also used to treat anthrax. Ciprofloxacin may mask or delay the symptoms of syphilis. It is not effective against syphilis infections.

Ciprofloxacin extended-release tablets are only used to treat urinary tract infections.

Ciprofloxacin belongs to the class of drugs known as fluoroquinolone antibiotics. It works by killing bacteria or preventing their growth. However, ciprofloxacin will not work for colds, flu, or other virus infections.

ciprofloxacin is available only with your doctor's prescription.

Before Using ciprofloxacin

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For ciprofloxacin, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to ciprofloxacin or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Appropriate studies performed to date have not demonstrated pediatric-specific problems that would limit the usefulness of ciprofloxacin in children. However, because of ciprofloxacin's toxicity, it should be used with caution, after other medicines have been considered and found ineffective. Ciprofloxacin oral liquid or tablets may be used in children to prevent anthrax infection after possible exposure, and to treat serious kidney infections.

Appropriate studies have not been performed on the relationship of age to the effects of ciprofloxacin extended-release tablets in the pediatric population. Safety and efficacy have not been established.

Geriatric

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of ciprofloxacin in the elderly. However, elderly patients are more likely to have age-related kidney or heart problems, or develop severe tendon problems (including tendon rupture), which may require caution in patients receiving ciprofloxacin.

Pregnancy

Pregnancy CategoryExplanation
All TrimestersCAnimal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Using ciprofloxacin with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

  • Tizanidine

Using ciprofloxacin with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Acarbose
  • Acecainide
  • Acetohexamide
  • Alosetron
  • Amiodarone
  • Azimilide
  • Bendamustine
  • Benfluorex
  • Bretylium
  • Chlorpropamide
  • Disopyramide
  • Dofetilide
  • Eltrombopag
  • Encainide
  • Flecainide
  • Gliclazide
  • Glimepiride
  • Glipizide
  • Gliquidone
  • Glyburide
  • Guar Gum
  • Ibutilide
  • Insulin
  • Insulin Aspart, Recombinant
  • Insulin Glulisine
  • Insulin Lispro, Recombinant
  • Lidocaine
  • Metformin
  • Mexiletine
  • Miglitol
  • Moricizine
  • Procainamide
  • Propafenone
  • Quinidine
  • Ranolazine
  • Sematilide
  • Simvastatin
  • Sotalol
  • Sucralfate
  • Tedisamil
  • Theophylline
  • Tocainide
  • Tolazamide
  • Tolbutamide
  • Troglitazone

Using ciprofloxacin with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

  • Aluminum Carbonate, Basic
  • Aluminum Hydroxide
  • Aluminum Phosphate
  • Betamethasone
  • Calcium
  • Chloroquine
  • Clozapine
  • Corticotropin
  • Cortisone
  • Cosyntropin
  • Cyclosporine
  • Deflazacort
  • Dexamethasone
  • Diclofenac
  • Didanosine
  • Dihydroxyaluminum Aminoacetate
  • Dihydroxyaluminum Sodium Carbonate
  • Dutasteride
  • Erlotinib
  • Fludrocortisone
  • Fluocortolone
  • Fosphenytoin
  • Hydrocortisone
  • Magaldrate
  • Magnesium Carbonate
  • Magnesium Hydroxide
  • Magnesium Oxide
  • Magnesium Trisilicate
  • Methylprednisolone
  • Olanzapine
  • Paramethasone
  • Phenytoin
  • Prednisolone
  • Prednisone
  • Rasagiline
  • Rifapentine
  • Ropinirole
  • Ropivacaine
  • Sevelamer
  • Triamcinolone
  • Warfarin

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Using ciprofloxacin with any of the following may cause an increased risk of certain side effects but may be unavoidable in some cases. If used together, your doctor may change the dose or how often you use ciprofloxacin, or give you special instructions about the use of food, alcohol, or tobacco.

  • Caffeine
  • Dairy Food

Other Medical Problems

The presence of other medical problems may affect the use of ciprofloxacin. Make sure you tell your doctor if you have any other medical problems, especially:

  • Brain or spinal cord disease, including hardening of the arteries in the brain, epilepsy or seizures—ciprofloxacin may cause nervous system side effects and make these conditions worse.
  • Diarrhea or
  • Heart rhythm problems (e.g., prolonged QT interval) or
  • Hypokalemia (low potassium in the blood), uncorrected—Use with caution. May make these conditions worse.
  • Kidney disease—Effects may be increased because of slower removal of ciprofloxacin from the body.
  • Organ transplant (e.g., kidney, heart, or lung) or
  • Tendon disorder (e.g., rheumatoid arthritis), history of—Use with caution. May increase the risk of tendon problems.
  • Sensitivity of the skin to sunlight—Patients taking ciprofloxacin may have an increased risk of severe reactions to sunlight.

Proper Use of ciprofloxacin

Take ciprofloxacin only as directed by your doctor. Do not take more of it, do not take it more often, and do not take it for a longer time than your doctor ordered.

ciprofloxacin comes with a medication guide. Read and follow the instructions in the guide carefully. Ask your doctor if you have any questions.

Swallow the extended-release tablet whole. Do not crush, split, or chew it.

You may take ciprofloxacin with or without food.

Drink plenty of fluids while you are taking ciprofloxacin. Drinking extra water will help prevent some unwanted effects of ciprofloxacin.

Do not take ciprofloxacin alone with milk, yogurt, or other dairy products. Do not drink any juice with calcium added when you take ciprofloxacin. It is okay to have dairy products or juice as part of a larger meal when you take ciprofloxacin.

If you are taking aluminum or magnesium-containing antacids, iron supplements, multivitamins, sucralfate, or zinc, do not take them at the same time that you take ciprofloxacin. It is best to take these medicines at least 2 hours before or 6 hours after taking ciprofloxacin. These medicines may keep ciprofloxacin from working properly.

Shake the oral liquid for at least 15 seconds just before each use. The oral liquid has small microcapsules floating in it. These microcapsules may look like bubbles or small beads. Do not chew the microcapsules when you take the oral liquid. Measure the oral liquid with the marked measuring spoon that comes with the bottle.

Keep using ciprofloxacin for the full treatment time, even if you feel better after the first few doses. Your infection may not clear up if you stop using the medicine too soon.

Dosing

The dose of ciprofloxacin will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of ciprofloxacin. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage form (extended-release tablets):
    • For urinary tract infections:
      • Adults—500 to 1000 milligrams (mg) once a day.
      • Children—Use and dose must be determined by your doctor.
  • For oral dosage form (suspension or tablets):
    • For infections:
      • Adults—250 to 750 milligrams (mg) twice a day, taken every 12 hours.
      • Children—Dose is based on body weight and must be determined by your doctor. The usual dose is 10 to 20 milligrams (mg) per kilogram (kg) of body weight every twelve hours.

Missed Dose

If you miss a dose of ciprofloxacin, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage

Keep out of the reach of children.

Do not keep outdated medicine or medicine no longer needed.

Ask your healthcare professional how you should dispose of any medicine you do not use.

Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.

You may store the oral liquid at room temperature or in the refrigerator. Do not freeze the bottle. Do not keep the oral liquid for more than 14 days. Throw away any unused liquid after 14 days.

Precautions While Using ciprofloxacin

If your symptoms do not improve within a few days, or if they become worse, check with your doctor.

Do not use ciprofloxacin if you are also taking tizanidine (Zanaflex®). Tell your doctor if you or your child are also using theophylline (Theo-Dur®) or other products that contain caffeine (e.g., coffee). Using these medicines together may increase risks for more serious side effects.

ciprofloxacin may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and require immediate medical attention. Call your doctor right away if you or your child have a rash; itching; hives; hoarseness; shortness of breath; trouble breathing; trouble swallowing; or any swelling of your hands, face, or mouth after you take ciprofloxacin.

Ciprofloxacin may cause diarrhea, and in some cases it can be severe. Do not take any medicine to treat diarrhea without first checking with your doctor. Diarrhea medicines may make the diarrhea worse or make it last longer. If you have any questions about this or if mild diarrhea continues or gets worse, check with your doctor.

Tell your doctor right away if you or your child start having numbness, tingling, or burning pain in your hands, arms, legs, or feet. These may be symptoms of a condition called peripheral neuropathy.

Ciprofloxacin may rarely cause inflammation or tearing of a tendon (the cord that attaches muscles to bones). This can occur while you are taking the medicine or after you finish taking it. The risk of having tendon problems may be increased if you are over 60 years of age, are using steroid medicines (e.g., dexamethasone, prednisolone, prednisone, Medrol®), have severe kidney problems, have a history of tendon problems (e.g., rheumatoid arthritis), or if you have received an organ transplant (e.g., heart, kidney, or lung). Stop using ciprofloxacin and check with your doctor right away if you have sudden pain or swelling in a tendon after exercise (e.g., ankle, back of the knee or leg, shoulder, elbow, or wrist), bruise more easily after an injury, or are unable to bear weight or move the affected area. Refrain from exercise until your doctor says otherwise.

Some people who take ciprofloxacin may become more sensitive to sunlight than they are normally. Exposure to sunlight, even for brief periods of time, may cause severe sunburn, skin rash, redness, itching, or discoloration. When you begin using ciprofloxacin:

  • Stay out of direct sunlight, especially between the hours of 10:00 a.m. and 3:00 p.m., if possible.
  • Wear protective clothing, including a hat and sunglasses.
  • Apply a sun block product that has a skin protection factor (SPF) of at least 15. Some people may require a product with a higher SPF number, especially if they have a fair complexion. If you have any questions about this, check with your doctor.
  • Do not use a sun lamp or tanning bed or booth.

If you have a severe reaction from the sun, check with your doctor.

Ciprofloxacin may cause some people to become dizzy, lightheaded, drowsy, or less alert than they are normally. Make sure you know how you react to ciprofloxacin before you drive, use machines, or do anything else that could be dangerous if you are dizzy or are not alert. If these reactions are especially bothersome, check with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

ciprofloxacin Side Effects

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common
  • Diarrhea
Rare
  • Abdominal or stomach pain
  • actions that are out of control
  • anxiety
  • arm, back, or jaw pain
  • blisters
  • bloody nose
  • bloody or black, tarry stools
  • bloody or cloudy urine
  • bluish color
  • blurred vision
  • burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
  • change in walking and balance
  • changes in skin color
  • chest pain or discomfort
  • chest tightness or heaviness
  • chills
  • clumsiness or unsteadiness
  • confusion
  • constipation
  • continuing ringing or buzzing or other unexplained noise in the ears
  • coughing
  • coughing or spitting up blood
  • dark urine
  • darkening of the skin
  • decreased frequency/amount of urine
  • difficult or labored breathing
  • difficulty in moving
  • difficulty in passing urine (dribbling)
  • difficulty in swallowing
  • discouragement
  • dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly
  • drowsiness
  • fast, irregular, pounding, or racing heartbeat or pulse
  • feeling of unreality
  • feeling of warmth
  • feeling sad or empty
  • fever
  • frequent urination
  • general feeling of discomfort or illness
  • greatly decreased frequency of urination or amount of urine
  • headache, severe and throbbing
  • hearing loss
  • heart stops
  • heartburn
  • hives or welts
  • increased blood pressure
  • increased thirst
  • increased volume of pale or dilute urine
  • indigestion
  • irritability
  • itching
  • itching of the vagina or genital area
  • joint stiffness
  • lack of appetite
  • large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • loss of appetite
  • loss of interest or pleasure
  • lower back or side pain
  • muscle pain or stiffness
  • nausea and vomiting
  • nervousness
  • nightmares
  • no breathing
  • no pulse or blood pressure
  • noisy breathing
  • numbness of hands
  • pain
  • pain during sexual intercourse
  • pain in the ankles or knees
  • pain in the joints
  • pain or discomfort in the arms, jaw, back, or neck
  • painful urination
  • painful, red lumps under the skin, mostly on the legs
  • pounding in the ears
  • puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
  • rash
  • redness of the skin
  • redness of the face, neck, arms, and occasionally, upper chest
  • restlessness
  • seizures
  • sensation of skin burning
  • sense of detachment from self or body
  • severe abdominal or stomach pain, cramping, or burning
  • shakiness and unsteady walk
  • shakiness in the legs, arms, hands, or feet
  • shortness of breath
  • skin rash
  • sleeplessness
  • slow or fast heartbeat
  • slow or irregular breathing
  • small red or purple spots on the skin
  • sore mouth or tongue
  • sweating
  • swelling
  • swelling of the face, feet, or lower legs
  • swollen, painful, or tender lymph glands in neck, armpit, or groin
  • talking, feeling, and acting with excitement
  • tenderness
  • thick, white vaginal discharge with no odor or with a mild odor
  • tightness in the chest
  • trembling or shaking of the hands or feet
  • trouble concentrating
  • trouble sleeping
  • unable to sleep
  • unconscious
  • unpleasant breath odor
  • unsteadiness, trembling, or other problems with muscle control or coordination
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • unusual weight gain
  • upper right abdominal pain
  • vomiting of blood or material that looks like coffee grounds
  • weight loss
  • wheezing
  • white patches in the mouth and/or on the tongue
  • yellow eyes or skin
Incidence not known
  • Abdominal or stomach cramps or tenderness
  • acid or sour stomach
  • back, leg, or stomach pains
  • belching
  • bleeding gums
  • blistering, peeling, or loosening of the skin
  • bloated
  • bluish-colored lips, fingernails, or palms
  • bone pain
  • cloudy urine
  • confusion as to time, place, or person
  • cough or hoarseness
  • cracks in the skin
  • diarrhea, watery and severe, which may also be bloody
  • difficult urination
  • difficulty in breathing, chewing, swallowing, or talking
  • double vision
  • drooping eyelids
  • dry mouth
  • excess air or gas in the stomach or intestines
  • excessive muscle tone
  • feeling of discomfort
  • feeling, seeing, or hearing things that are not there
  • feeling that others are watching you or controlling your behavior
  • feeling that others can hear your thoughts
  • flushed or dry skin
  • fruit-like breath odor
  • full feeling
  • general body swelling
  • hallucinations
  • high fever
  • holding false beliefs that cannot be changed by fact
  • hyperventilation
  • increased hunger
  • increased sensitivity to pain
  • increased sensitivity to touch
  • increased urination
  • inflammation of the joints
  • irregular heartbeats
  • irregular or slow heart rate
  • joint or muscle pain
  • loss of heat from the body
  • loss of sense of smell
  • lower back or side pain
  • muscle aches
  • muscle tension or tightness
  • muscle twitching or jerking
  • muscle weakness
  • nosebleeds
  • pain, inflammation, or swelling in the calves, shoulders, or hands
  • pains in the stomach, side, or abdomen, possibly radiating to the back
  • pale skin
  • passing gas
  • rapid heart rate
  • red skin lesions, often with a purple center
  • red, irritated eyes
  • redness, soreness, or itching skin
  • rhythmic movement of muscles
  • scaly skin
  • severe mood or mental changes
  • severe tiredness
  • sore throat
  • sores, ulcers, or white spots on the lips or in the mouth
  • stomach discomfort, upset, or pain
  • stomach pain, continuing
  • sudden decrease in the amount of urine
  • tingling in the hands and feet
  • uncontrolled eye movements
  • unsteadiness or awkwardness
  • unusual behavior
  • unusual bleeding or bruising
  • unusual excitement, nervousness, or restlessness
  • unusual weight loss
  • vaginal yeast infection
  • weakness in the arms, hands, legs, or feet

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Less common
  • Runny nose
  • sneezing
  • stuffy nose

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

The information contained in the Thomson Healthcare (Micromedex) products as delivered by Drugs.com is intended as an educational aid only. It is not intended as medical advice for individual conditions or treatment. It is not a substitute for a medical exam, nor does it replace the need for services provided by medical professionals. Talk to your doctor, nurse or pharmacist before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Only your doctor, nurse, or pharmacist can provide you with advice on what is safe and effective for you.

The use of the Thomson Healthcare products is at your sole risk. These products are provided "AS IS" and "as available" for use, without warranties of any kind, either express or implied. Thomson Healthcare and Drugs.com make no representation or warranty as to the accuracy, reliability, timeliness, usefulness or completeness of any of the information contained in the products. Additionally, THOMSON HEALTHCARE MAKES NO REPRESENTATION OR WARRANTIES AS TO THE OPINIONS OR OTHER SERVICE OR DATA YOU MAY ACCESS, DOWNLOAD OR USE AS A RESULT OF USE OF THE THOMSON HEALTHCARE PRODUCTS. ALL IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE OR USE ARE HEREBY EXCLUDED. Thomson Healthcare does not assume any responsibility or risk for your use of the Thomson Healthcare products.

  • Ciprofloxacin MedFacts Consumer Leaflet (Wolters Kluwer)
  • Ciprofloxacin Prescribing Information (FDA)
  • Ciprofloxacin Professional Patient Advice (Wolters Kluwer)
  • Cipro Prescribing Information (FDA)
  • Cipro Consumer Overview
  • Cipro Detailed Consumer Information (PDR)
  • Cipro MedFacts Consumer Leaflet (Wolters Kluwer)
  • Cipro XR Prescribing Information (FDA)
  • Cipro XR Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)
  • Proquin XR Consumer Overview
  • Proquin XR Prescribing Information (FDA)
  • Proquin XR Extended-Release Tablets MedFacts Consumer Leaflet (Wolters Kluwer)
  • Proquin XR Detailed Consumer Information (PDR)